A clinical study on the effect of Tiaoli-Qixue decoction on bleeding and coagulation during perioperative period of total hip arthroplasty

Abstract

Objective To explore the effect Tiaoli-Qixue decoction on bleeding and coagulation during perioperative period of total hip arthroplasty (THA). Methods A total of 180 THA patients who met the inclusion criteria were randomly divided into three groups with 60 cases in each group. All patients underwent routine anti-infection treatment after unilateral THA through lateral hip approach. The patients took the Tiaoli-Qixue decoction 3 days before THA in the treatment group. The patients in the Xuesaitong control group received intravenous Xuesaitong on the day of operation and rivaroxaban tablets were administered orally on the day of operation in the western medicine control group. The continuous medication was administered until 7 days after operation in three groups. The amount of hemorrhage and drainage after operation were recorded and the total amount of dominant hemorrhage was calculated. The Degao M4 semi-automatic hemagglutination instrument was used to detect plasma D-dimer level and observe thrombosis. Harris scale was used before and after operation to calculate the excellent and good rates of Harris score. Results The total amount of dominant hemorrhage (376.67 ± 61.44 ml vs. 400.08 ± 61.16 ml, 413.33 ± 53.76 ml, F=5.963), intraoperative hemorrhage (165.50 ± 15.67 ml vs. 174.75 ± 14.68 ml, 175.42 ± 11.13 ml, F=9.452) and postoperative drainage (211.17 ± 58.12 ml vs. 225.33 ± 56.93 ml, 237.92 ± 54.28 ml, F=3.370) in the treatment group of traditional Chinese medicine were significanlty less than those in the Xuesaitong control group and the Western medicine control group (P<0.01 or P<0.05). On the 7th day after operation, there were 6 cases of thrombosis in the treatment group of traditional Chinese medicine, 4 cases in the Xuesaitong control group and 4 cases in the Western medicine control group. There was no significant difference between the three groups (χ2=0.667, P=0.881). Six months after operation, the excellent and good rate of that the treatment group of traditional Chinese medicine was 45.0% (27/60), which of the the Xuesaitong control group was 11.7% (7/60), and which of the the Western medicine control group was 13.3% (8/60). There was significant difference among the three groups. Conclusions The Tiaoli-Qixue decoction bleeding and coagulation can reduce the amount of dominant bleeding during perioperative period in patients with THA, and effectively prevent and treat deep venous thrombosis of lower limbs after THA. Key words: Arthroplasty, replacement, hip; Perioperative period; Tiaoli-Qixue decoction; Hemorrhage; Bleeding time